This invention relates to the field of endotracheal tubes for use by physicians in opening the airways of patients in need of such treatment, and devices to hold such endotracheal tube in the desired position.
Prior art devices to hold the endotracheal tube in position include a frame-like member which is secured in place over a patient's mouth and held by a strap around the back of the patient's head or neck, such frame member including a slot in which the endotracheal tube is placed after which it is tied to the frame and held within this slot formed in the frame member. However, it is difficult if not impossible to hold the endotracheal tube securely by this method and prior art devices so as to prevent the tube from reciprocal movement inwardly and outwardly of the patient's mouth, throat and trachea. In other words, the endotracheal tube is subject to movement inwardly and outwardly of the patient's trachea when, for example, the patient moves his head, attempts to turn over, attempts to arise and other bodily movements. Such inward and outward movement of the endotracheal tube can cause severe discomfort to the patient and under certain circumstances, can also cause irritation and injury to the lining of the throat and trachea of the patient.
Somewhat related prior art devices are tracheostomy tubes, but they require an incision through the patient's neck and insertion of the tracheostomy tube through such incision into the throat and trachea of the patient. Such devices are not typically used if the patient's condition will permit the use of an endotracheal tube through the patient's mouth, and in some cases through the patient's nose, down through the internal passageways to the patient's trachea. The use of a tracheostomy tube requires surgery with its attendant complications such as infection, hemorrhage and the like.
Examples of prior art devices of this kind are disclosed in prior art U.S. Pat. Nos. 4,315,505; 4,304,228; 4,270,529; 4,235,229; 4,223,671; 4,033,353; 3,774,616; 3,693,624; 2,820,457; and 2,693,182.
Endotracheal tubes include an inflatable cuff at the lower end for helping to open the air passageway, to aid in suction of the material from the trachea of the patient through the tracheal tube, and to block the area surrounding the tube so food and fluids cannot pass into the bronchi and lungs. A small flexible air line extends from the inflatable balloon portion alongside the wall of the endotracheal tube and extends out through the mouth of the patient having an adapter or a mouthpiece connected at the outer end of the air line through which the cuff can be inflated. The holder for the endotracheal tube in accordance with this invention includes a sleeve having an inner diameter corresponding to the outer diameter of the endotracheal tube, and is slightly larger to receive the endotracheal tube through the sleeve for sliding movement but small enough to securely hold the tube in place when fastened to the sleeve portion of the holder by adhesive strips or the like.
The endotracheal tube should preferably be moved outwardly periodically for a short distance and then reinserted to its original position. It is not necessary to completely remove the endotracheal tube from the patient each day. In order to facilitate the outward movement of the endotracheal tube and reinsertion to its original position, a rack and pinion assembly is incorporated in the holder and endotracheal tube in accordance with this invention. This enables the physician to move the tube inwardly and outwardly by merely rotating the pinion gear, and he can easily determine precisely how far outwardly the endotracheal tube is being moved and also the precise position to reinsert the endotracheal tube by markings on the wall of the tube adjacent the gear rack formed thereon.